CHARLES LEON DAVIS JR MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****30

License Status

NOT RENEWED

Business

Title

First Name

CHARLES

Middle

LEON

Last Name

DAVIS

Suffix

Business Name

CHARLES LEON DAVIS JR MD

Original Issue Date

09/16/1981

Effective Date

09/16/1981

Expiration Date

07/31/1987

City

EAST ST LOUIS

State

Zip

62205

County

SAINT CLAIR

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006